Crohn's Disease

“Infection and auto-immune disease are the opposite sides of the same coin.”

Dr. William Chamberlin

Gastroenterologist

There is growing evidence that Crohn’s Disease is infectious. To read PubMed journals and other relevant scientific literature on this subject, please visit my ‘Scientific Articles’ section. Also, my eBook “Wake Up to the Truth Behind Crohn’s Disease’ has a lot of information and resources on this topic. In the intro to this ‘Protocol’ section, I will try to summarize the basics.

Science has revealed that Crohn’s Disease is a Mycobacterium Avium Paratuburculosis infection; a bacterium found in our dairy supply. Identical disease patterns of IBD are found in a certain percentage of cows, otherwise known as ‘Johne’s Disease.’ There are many documented cases of the same bacterium being found in Colitis patients (I am one of these cases, see my labs here). While Crohn’s Disease is playing out to be associated with this bacterium over 98% of the time, Colitis has not statistically proven to be Mycobacterium as consistently.

For the most up to date info and resources on the study of Mycobacterium (in relationship to Crohn’s Disease) can be found at https://humanpara.org/ , including footage of the MAP conference that takes place in Berkeley every year. A LOT has transpired in this arena just in the past 5- 10 years.

Imagine two boxes sitting on the doctor’s desk. One is labelled “test” and the other is labelled “treatment.” If the disease is labelled an autoimmune disease, then the test box will contain tests for inflammation, genetics, antibodies and other health assessments. The treatment box will contain therapies that control inflammation and symptoms.

However, if the disease is labelled an infection, then the test box would contain cultures and bacterial assays, and the therapy box may have to change to perhaps include antibiotics.

MAP Testing and Vaccine!

The new MAP test currently being developed is a simple, smart test which can be done on blood samples or routine gut biopsies. It is highly accurate and quantitative and will help to dispel this kind of diagnostic uncertainty for both Crohn's Disease and Ulcerative Colitis.

Otakaro Pathways is a lab in New Zealand testing for MAP. There are 2 others but Otakaro is by far doing the most accurate testing. It is a little bit of a challenge getting your blood sample to them, but they give thorough instructions on how to do so. John Atkins will determine your results and thoroughly go over them with you himself. Explore Otakaro here. Traaditional labs so not have the technology to see this bacterium; detection requires a highly sophisticated microscope as it lacks a cell wall.

I highly suggest that you educate yourself on this topic and learn the most up to date info on inflammatory bowel conditions (your gastroenterologist is most likely clueless). There is still a lot to learn of course, however, I have always strongly questioned the term “auto-immune’ disease in reference to both Crohn's Disease and Ulcerative Colitis. The term auto-immunity became a fad in the 1960’s and 70’s; when they didn’t know the cause of a disease or understand its mechanisms, they threw the label auto-immune at it. Not to say the immune system is not involved- of course it is. Anyone diagnosed with Crohn’s and Colitis are dealing with genetic mutations where the immune system is failing to recognize certain pathogenic bacteria, and disease ensues. For a more comprehensive look into this subject, read my ebook. The point of this section is to offer a protocol, but to truly implement a protocol, you must understand the point of it fundamentally. If you choose to remain in the dark on the most cutting edge information and treatment on this condition, you will likely remain ill…….education not only empowers you, but logistically aids in understanding these protocols. Taking the regime very seriously, not diverting form dosing is key- this is optimally accomplished when you understand what you are truly dealing with. The infections that cause these diseases are as nasty as they come, and insanely difficult to kill. Yes- it is possible.

I believe in following a Functional Medicine approach (the 4 R’s) which offers a framework around addressing gut infection: Remove, Replace, Reinoculate, Repair. Below is the 4 R Protocol, followed by a Chinese Medical interpretation. . In my experience, combining both Western and Eastern schools of thought will offer you the greatest potential in healing.

Reading my ‘Root Cause’ article (that you will receive for free by subscribing to my site from home page) is a crucial addition in understanding my approach to reversing gut disease symptoms. It is very educational and gives a very comprehensive look at my 4-step approach.

The first step- REMOVE, is much broader for Candida, SIBO, and Irritable Bowel Syndrome. Unfortunately, there are very few compounds that have proven to truly ‘kill’ the infection of Crohn’s Disease. It is very common with this condition to have multiple infections going on, as once a primary infection such as Mycobacterium takes hold, candida and other things like Klebsiella Pneumonia and Campylobacter easily setup shop (I had them, and almost always see these co-infections in my patients’ labs). Therefore, weaker antimicrobials such as Olive leaf and Grapefruit seed extract might surely help you, but not address the primary infection. I will give you options for antimicrobials, however, you will most likely need to rotate them every 3 weeks and sometimes the best results come from taking 2-3 compounds at a time. I know that this sounds excessive, however, the most cutting edge treatment for Crohn’s from a pharmalogical standpoint includes taking 2-3 antibiotics at a time (Rifaxamin, Clofazimine and Clarithromyacin). We are essentially mimicking this approach, just doing it naturally. To me, it has always made the most sense to at least TRY to address infection (and disease in general) with nature first……if that fails, then drugs can be considered. As far as alternative doctor’s go, I am (I think) a rarer breed- sometimes we need pharmaceuticals. They have their place, and we are lucky to have science and technology at our fingertips. My goal with patients is to guide them in healing and find quality of life again. If drugs become the obvious and necessary route after all holistic approaches fail, then so be it. Sometimes both are ideal, even complimentary. Botanicals and natural compounds usually come with a fraction of the side effects as drugs, and can save us from using atomic bombs on our microbiomes……now how could that be bad.

Diet

Diet is paramount in eradicating any type of infection. Consider a Paleo or low FODMAP diet (see my diet section here). Eating carbs and sugar, yes even fruit, will just continue feeding this infection. Remember…it’s just temporary. You will be glad you did. No supplements or probiotics you take will hold and prove effective if you keep eating carbs that ferment in the gut and feed the pathogenic bacteria. You are wasting your money on supplements if you continue to eat carbs and sugar.

Step #1: REMOVE

The main 2 compounds that I have consistently seen results in killing the infection that is Crohn's are:

Wild Oil of Oregano – American Herb and Spice, one of only 2 companies that are making the real deal. The rest are making some synthetic version that should not be used. The other company is Joy of the Mountains- they are more expensive. I try to carry the best AND most affordable supplements, as I have experienced firsthand the financial strain of illness.

Studies have shown that cinnamon oil and peppermint oil can kill Mycobacterium as well as other very stubborn, chronic infectious microbes. I did not take these compounds for my UC and have used them very little clinically. If you do not get the results you are seeking with suggested compounds, however, they might be worth trying. Both oils, while volatile and effective in killing most microbes, can be irritants. Well, so can oil of oregano. Some trial and error is needed to find which compounds work for you.

Below are other antimicrobial formulas that can be supportive of coinfections, that also do include some Oil of Oregano (hence simultaneously addressing primary infection). I find it best to take one of the above formulas in combination with one of these antimicrobial blends. Rotation is often very necessary.

*Dosing is key. Misguided dosing schedules are the biggest reason I see people fail to get results with botanicals. For the first 2 weeks you must take the antimicrobials every 2-3 hours. Bacteria can double every 20 minutes (if it wants to). You must be committed to a very strict regime if you want results. After the second week, you can begin to taper down. So if you are getting 5-6 doses in for the first 2-3 weeks, try tapering down to 4-5 doses, then 3 and so on. If symptoms begin to resolve but hen creep back up when taking smaller doses, go back up to higher dose for another week or two. Treatment time is DRASTICALLY different per person. Some people have to intermittently take antimicrobials to keep infection at bay. If botanicals do not resolve symptoms, pharmaceuticals should be considered.

*Take soil based probiotics at bed time, 3 hours from last dose of antimicrobial. In theory, if a potent antimicrobial such as the ones listed are taken too close to a probiotic, the antimicrobial could weaken or altogether eliminate the effectiveness of the probiotic.

To eradicate infection, you will need antimicrobials AS WELL AS bio-film busters. Infectious bacteria create colonies, forming a glue-like ‘shield’ around them for protection. You have to penetrate through the biofilms to even get access to killing the pathogens. Often when results are elusive, it is because the compound being used is not able to get through the biofilm.

NAC- Thorne: N-Acetycysteine *very important. It pulls the iron out of the biofilm, is the precursor to glutathione and also a powerful antioxidant. Do not exceed 1,000 mg daily

*I do not find enzymes (i.e. the popular product Interphase Plus by Klaire Labs) to be a strong enough biofilm reducer. Clinically I failed to see results with this product.

Die-off and Detoxification

Die-off (herxheimer effect) of microbes is a huge issue for a lot of people. As these infectious pathogens die, they release toxins into the blood stream causing symptoms such as fatigue, headache, bodyache, joint pain, nausea, diarrhea etc. To greatly reduce such occurrences, one needs binders. In my practice, I will not prescribe anti-microbial supplements without binders. This is essential, and very important to prevent recirculation of toxins. While of course binders will not rid every single toxin out of your body, they significantly lighten the load. If toxins are just sitting in your body, they pose risk for damaging cells.

* Binders are very safe with little to no side effects except constipation- see below.

I personally and clinically prefer binding “formulas,” meaning combinations of multiple binders. As different binders have varying affinities for certain substances, formulas are the best option because you are covering all bases. Choose a binder:

Vitality Detox Drops (Zeolite): This is by far the most superior zeolite on the market; excellent for mycotoxins and mold which I find is an issue for many people struggling with digestive issues. Combining one of the above GI detox formulas with vitality drops ensures complete detoxification and is my favorite combo of choice.

Charcoal- Charcoal is the best thing I’ve found to stop bleeding. In fact, the Chinese include charcoal in their pharmacy and It is in the ‘stop bleeding category.’ I suggest activated charcoal or carbonized bamboo charcoal as it has been found to have a greater surface area for binding. Charcoal is excellent for binding bacterial endotoxins also. It can be taken every few hours. * Both GI detox formulas contain activated charcoal.

Green Calcium Bentonite Clay by BioPure- Clay is another really effective binder of mycotoxins and endotoxins. Sometimes IBD’ers do not tolerate clay at high doses as it is very dense in nature. Other folks it proves to be almost magical in its contribution of mopping up infection. You will have to explore. The GI detox formulas contain small amounts of clay which is ideal, as clay in very small amounts is usually tolerable.

While taking binders it is VERY IMPORTANT to increase water intake. Binders slow down digestion and can cause constipation. It is almost guaranteed that if you’re on binders you will need to take higher doses of Magnesium Citrate. This form of Magnesium can be used as a mild, gentle laxative. It is absolutely necessary to keep the bowels moving to prevent toxin recirculation. If you are suffering from diarrhea, as many Crohn’s sufferers’ are, binders might be ideal.

Colon Rx – Designs for Health: Very safe and effective formula for constipation or sluggish bowels while taking binders. Contains Triphala (gentle Ayurvedic herb) for constipation as well as Magnesium hydroxide.

Other ideas to support detoxification:

Sweating- anything and everything you can do to sweat, including saunas, hot yoga, fast walking, bike riding.

With a Crohn’s Disease diagnosis, digestive enzymes can be lacking. Digestive enzymes can really aid in the breakdown of food- form carbohydrates, to protein, lipids, and vegetable fibers. Sometimes digestive enzymes taken with meals can help reduce symptoms such as gas and bloating. Often if someone with UC has taken lots of pharmaceuticals, they are depleted of digestive enzymes, which can really help with breaking down food.

I offer both formulas because the Xymogen product does not contain hydrochloric acid, while the Designs for Health formula does. Usually, people with IBD do not respond great to HCL (too abrasive), but occasionally someone will respond fabulously. The DFH formula has a very low dose of HCL, so if you want to experiment, that formula is ideal.

Also, fiber is a really good idea for those suffering from Ulcerative Colitis.

PaleoFiber – Designs for Health: Contains 12 different types of soluble and insoluble fiber. Fiber can be hugely beneficial for Ulcerative Colitis. * Contains very small amount of psyllium husk

FiberMend -- Thorne: Soluble fiber blend. *Does not contain any psyllium husk for those that might not tolerate it well.

Step #3: REINOCULATE

I have somewhat different views on probiotics, especially for Crohn’s and Colitis Traditional probiotics never really did anything for me (I have Colitis), and let me tell you, I tried every brand under the sun. I find this pretty common in IBD. I always really wanted them to help my patients, they just didn’t. Firstly, there is evidence now that states the ‘regular’ probiotics cannot possibly survive the acidity of the stomach. Furthermore, the probiotic industry took off so fast, no one really questioned it. There is actually very little, if any, regulation on probiotic supplements. Any company can make a probiotic and can make all kinds of claims, use inferior strains that cannot possibly colonize (but are dirt cheap), and sell it for crazy expensive prices. And, for a probiotic to actually stay ‘alive,’ it definitely has to remain refrigerated; non-refrigerated probiotics are dead. Now, how many of these companies do you think are actually paying for their products to be shipped around the country refrigerated? Not many….

Now, I do believe that probiotic enemas can be very beneficial for Crohn’s Disease and Ulcerative Colitis as I have experienced their benefits first hand. In fact, they pulled me out of a flare several times. I did have a few flares where the enemas didn’t cut it, but they are still a powerful tool to have in one’s arsenal. If you have resistance about doing this, get over it. When you put a real, quality probiotic by enema in your rectum, the acidity of the stomach is bypassed, and the strains can actually colonize. This requires a powder form of a probiotic in large amounts. The best company I have found, by far, is Custom Probiotics. They make an 11 strain powder form probiotic that is the real deal. The company is owned and operated by a Microbiologist who knows what he’s doing. Recipe for probiotic enema below.

Soil organism probiotics, however, are a completely different thing. They DO survive the acidity of the stomach. They include strains that help our immune system recognize the invaders, and also produce natural antibiotics in the gut lining. They are incredibly potent and should be taken in VERY low doses to begin. I wrote a blog with all the essential info on these types of spores- read here. Re-populating with soil based organisms can be extremely beneficial in cases of inflammatory bowel disease. Very important to read up on them first, check out my blog on themhere.

Total Gut Restoration Kit – Microbiomelabs: This kit is phenomenal is addressing gut infection. I use this kit after the 3 week mark of antimicrobials. Includes the revolutionary Measporebiotic, MegaPrebiotic (potent food for MegaSpore, rendering it 5 times more effective), and MegaMucosal to repair and restore gut lining.

Buy a fleet saline enema bottle at Wallgreens, empty it out and rinse well with hot water. Fill back up ¾ of the way with filtered (non-chlorinated) water. Put 4-6 teaspoons of powdered probiotic formula in bottle. Gently shake; you want to disperse powder but not too much to risk damaging strains. Insert and try to retain for as long as possible- overnight is ideal, it will just get absorbed. I know some IBD’ers, especially if flaring, cannot retain overnight or long at all. Even 20-30 minutes will provide some benefit, longer is always better.

You can repeat this every night or every other night for as long as you wish, until you see improvement. Usually doing one every night for 3-5 days will bring some degree of benefit.

Step #4: REPAIR

The mucosal lining of intestines has been compromised. The infection caused inflammation, hence resulting in leaky gut. To repair the tight junctions of the colon walls, support the body with things such as glutamine and collagen. Repairing the lining of the intestines is no small feat. However, once you really eradicate the infection, the lining will begin to repair itself naturally because the inflammation will have greatly decreased. While this healing process will organically occur, it is really beneficial to take supplements to support and enhance this process. In my opinion, collagen is ideal along with soothing herbs. Collagen is made up of powerful amino acids (and they are not synthetic, they are ‘food based’) that the cell walls of our colons need to rebuild tissue. For a more in depth look into leaky gut, what's involoved in repairing the lining of the intestines with supplements and a look at the best amino acids for this process check out my blog "Plugging Away the Holes of Leaky Gut."

***Glutamine Awareness ***

Glutamine has shown fantastic results for some, others have an adverse reaction to it. If you have severe leaky gut, glutamine should be approached with caution. Glutamine is the precursor to glutamate- one of two excitatory neurotransmitters in the brain. Because of the gut-brain axis (they intricately affect one-another), glutamine can potentially cause extreme anxiety among other symptoms in some people. Amino acid therapy is not black and white, it can go either direction. Glutamine supplementation has become a fad in the alternative medicine world yet alternative doctors are not educating people on the potential side effects. I have seen equally as many patients (as well as myself) have an adverse reaction to glutamine as I have positive. Now, for those that glutamine benefits, it seems to really benefit, which is why I include it and not dismiss it entirely. However, this comes with some reservation. As always, be your own detective, monitor closely, and begin with small doses.

Glutamine – GI- Revive by Designs for Health: this is one of the best as far as formulas that include glutamine go. It also includes glucosamine and soothing herbs that aid in repairing the lining such as slippery elm, marshmallow and licorice root.

MegaMucosal- Microbiomelabs: This is probobly my favorite simply because it is also Is an IgG product, which is like turning the immune syetem on while simultaneously repairing the gut lining.

Gastromend – Designs for Health: alternative for glutamine. Superb formula for mucosal repair that also includes soothing herbs as well as mastic gum, zinc carnosine and Vitamin U.

Great Lakes Collagen Hydrolysate- there are many sources out there these days. Some are very expensive and I’m not sure they need to be. Again, it’s become a fad. If you are on a budget, Great Lakes is just fine (1/3rd of the price as others). Otherwise Vital Proteins and Dr. Ax have great options/claims on their collagen.

Slippery Elm and Marshmallow Root- These herbs are incredibly soothing to the lining of the gut. If you have a lot of pain and cramping, these herbs, in very high doses, could be your new best friend. While I was healing my colon, these were a staple. I needed VERY high doses and could not afford taking ¼ bottle of pills of them. If this is the case for you, order these herbs by the pound from one of the following companies. Make smoothies and throw tablespoons of each in. Or put a heaping teaspoon of each in hot water and make a tea. You can do this multiple times a day. These herbs are very gentle and have zero side effects. They become quite gooey or gelatinous if you let them sit for too long in a smoothie or tea. There’s a reason why all of the top supplements for mucosal healing include these herbs. They really work.

This concludes the 4 R Protocol. Of course there are endless amounts of other supplements that could be beneficial in healing. I’m not a huge fan of Vitamin C (ascorbic acid) because it is made from corn, usually GMO, and folks with digestive disturbances often do not tolerate it well, even if they don’t realize it. Only a food sourced supplement of Vitamin C should be taken. Other than that, take whatever else feels right for your body. The ONE additional supplement that I feel everyone should take without question (especially those with bowel issues), is Magnesium.

Magnesium

Magnesium is responsible for well over 300 biochemical processes in the body. 300! It regulates blood sugar, which in turn can prevent diabetes. It relaxes arteries, which means it has the ability to lower blood pressure. It also prevents calcium build up in the body that could make the arteries harden, as it chelates extra calcium. Of course, it is essential to digestive health because it is necessary for digestive enzyme synthesis. And last but not least- it seriously relaxes the nerves and basically allows the body to take a deep breath. Great for tight muscles and restless leg syndrome as well. This is why you see all these ‘Calm’ type formulas that are ridiculously over-priced…..it’s just Magnesium! Most of those formulas do not contain a very high quality, absorbable form of Magnesium. If you are taking Magneisum Citrate, you are absorbing very little, if any.

Magnesium Chelate (Powder) – Designs for Health: most bioavailable form of elemental magnesium in powder form for those who don’t want to take more pills, or want to put in smoothie (orange flavor).

Colon Rx – Designs for Health: for those that want to take magnesium strictly as a mild laxative. In this case, one of the above formulas should also be taken.

A Traditional Chinese Medicine Perspective of Crohn’s Disease

Traditional Chinese Medicine (TCM) encompasses how the body interacts with all aspects of life and the environment, seasons, weather, diet and emotional states. It is a system that emphasizes pattern recognition per each individual. It sees the key to health as the balanced functioning of the body, mind, spirit and holds that this balance depends on the unobstructed flow of Qi, or “life force” energy throughout the body along pathways known as ‘meridians.’ Traditional Chinese Nedicine practitioners see disease as the result of disruption in the circulation of Qi (in the very simplest of terms).

Chinese Medicine strongly identifies each person as very unique in their disease pattern. For example, if a Chinese practitioner had ten Irritable Bowel Syndrome patients standing before them, each might be diagnosed very differently. Now of course there may be some underlying diagnostic similarities among these ten people…….but they could perhaps each have different patterns in how the disease originally ensued. Each person is identified according to their individual constitution, each course of treatment (what herbs to prescribe and where to put needles) specific to their pattern of disharmony. Perhaps this is not too far off from Western Medicine- one person responds great to a biologic, another does not. Chinese Medicine is simply far more intricate. Point being- every person is vastly unique in regard to what their needs are for healing. This is the beauty of Chinese Medicine.

Differing constitutions of individuals will elicit a unique Chinese Medical diagnosis. I do know that Chinese theory will not make sense to most, but I find it important to at least offer the most common differential diagnosis in Chinse terms so that the reader can begin down the path of understanding their illness specific to their constitution. This differential diagnosis could also be a contributing factor as to why people respond differently to medications/supplements.

Chinese Differential Diagnosis of Crohn’s Disease

Damp-heat Accumulation

Spleen and Stomach Deficiency

Liver overacting on Spleen Qi

Spleen and Kidney Yang Deficiency

Blood Stagnation

Oriental medicine sees things in terms of energetics; heat is basically a synonym for inflammation Damp-heat accumulation is almost always involved in Crohn’s and Colitis; it is just a question as to whether or not it is the primary pattern of disharmony. The Spleen Qi is usually affected; in Chinese Medicine the strength of our Spleen determines our overall digestive health. In long- term, chronic Crohn’s Disease the Yang (upward flow) of the Kidney’s is hindered. For those with remittent sharp, knife-like stabbing pain, blood stagnation is present.

In my shop I offer the 3 most common Chinese Formulas prescribed for Crohn’s Disease- these formulas mostly address damp-heat. It takes a skilled Chinese Practitioner to thoroughly interview a person, find out signs and symptoms and accurately diagnose according to Chinese medical theory. I certainly cannot offer all Chinese Formulas in my shop as there are hundreds. However, should we work together, I can investigate your case specifically and prescribe accordingly. Together we can discover which of the above patterns are dominant in your condition.

The Curing Pill formula is like gold for any IBD patient, symptomatically. I could not have gotten through my active UC days without this one- any time there’s pain (qi/blood stagnation), gas/bloating/distension (damp-heat), or when symptoms ensue after eating a meal, curing pills will do the trick. Of course dosage is key. This formula will drain heat (inflammation) form the intestines from a root level.

Often 2 Chinese Herbal formulas are needed- one to address the primary disharmony and another for the secondary pattern of disharmony. I will be writing further material on each disharmony so that individuals can become educated on the nuances of each.

Of course Chinese herbs are only a part of my approach in treating Crohn’s or Colitis, but they are a powerful adjunct to any regime aimed at resolving symptoms. Chinese herbs can energetically change the terrain; clear heat (inflammation). These formulas, combined with functional medicine strategies can be a powerful means of reversing even the most stubborn cases of UC (like mine).

For a more in depth discussion of what Chinese herbs are and what exactly they do, please read my blogWhy Chinese Herbs. It will give you a more in depth understanding of the energetics of herbs and how herbal prescriptions are prescribed per individual. Chinese herbal medicine is sophisticated alchemy……not hocus-pocus. For the aforementioned 10 patients, each one would receive a unique herbal prescription. Yes there would most likely be consistency in some of the primary herbs used. Of course it would depend on what the patients’ symptoms are at that moment as well, i.e. to stop bleeding vs stop pain (or both).

Chinese Medicine and Functional Medicine run parallel in their approach to treating IBD when it comes to botanicals. Chinese medicine advises Huang Lian Su (Berberine) for diarrhea type cases, and Da Suan (garlic) for constipation type IBD. This may be interesting to take into account when choosing supplements. Chinese medicine is very aware of the energetics of a plant; they observe every herb as either being hot, warm, cold, cool etc. Every patient is observed uniquely- some patterns would benefit from more cooling herbs (hot, smelly, explosive diarrhea) and some might benefit more from warming, dispersing herbs (constipated, distended, bloated cases). Of course these are huge generalizations- a skilled oriental practitioner can pick up on the nuances in each patient, and often use a combination of herbs energetically, with precision (targeting specific organs). This is just to get you understanding the fundamentals of Chinese Medicine. It also lends itself to deeper understanding of why some supplements (specifically anti-microbials in this case) may work for one person and not for you- plants are vast in their properties and application. This is why it often takes a little trial and error to find the herb(s)/formulas that work for YOU. These days, we are so disconnected from the actual life of a plant, but our ancestors (who actually went into the woods, picked and cultivated them) were very aware of their ‘vibration.’ Nowadays, we pick a bottle off the shelf, take a pill and want it to perform miracles. It’s just not that simple……our bodies are all so unique. Herbalism honors this- whether you do or not. So keep searching for the plants your body needs. And if your really inspired- get to know the plants that heal you. It can be a lifelong love affair.